Repost: Middle Age Suicide

I am reposting an article by Dan Fields from “The Good Men Project” Magazine which was originally posted here.

“I belong to a group that has an unusually high rate of dying by suicide. No, I don’t belong to a cell of terrorists in training. I’m not a soldier or veteran with multiple deployments to Iraq or Afghanistan. I’m not a prison or jail inmate. And I’m not a doctor (physicians have easy access to drugs and understand their lethality). What high-risk group do I belong to? I am a middle-aged white man.

Men have long had higher rates of suicide than women, and whites in the United States are more likely to kill themselves than are African, Hispanic, or Asian Americans. But it’s only in recent years that the middle-aged have overtaken older people as the ones most likely to die by suicide.

In 2007 (the latest year for which statistics are available), people aged forty-five to fifty-four had the highest suicide rate of any age group: 17.7 per 100,000. (The national average was 11.5 per 100,000.) And the rate for fifty-five to sixty-four-year-olds showed the greatest increase from the previous year.

Researchers don’t yet know why midlifers are becoming more vulnerable to suicide, especially since studies have found that middle age is generally the happiest time of life for most Americans. As a forty-five-year-old white guy, I was curious to know what makes my demographic group so self-destructive. After talking with experts, here’s what I learned.

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“Women seek help—men die.” This quote from a 1990 medical journal article is an overgeneralization, of course. There are plenty of women who don’t seek help for their emotional distress. After all, women in the United States are three times more likely to attempt suicide than men. But “men tend to hold their own counsel,” says psychiatrist Yeates Conwell, co-director of the Center for the Study and Prevention of Suicide at the University of Rochester. “They often don’t build supportive networks that allow them to share their concerns with others.”

Men are also more likely to drink heavily when feeling distraught, and to reach for guns in order to kill themselves. Nearly sixty percent of suicides among males occur by firearms, while the most common method among women is overdose/poisoning. Guns tend to be more lethal than pills, and this helps explain why there are four male suicides for every female suicide. (Some ninety percent of all people who die by suicide have a diagnosable mental illness or substance use disorder.)

There’s even evidence that men are more likely than women to feel there is a stigma attached to a “failed” suicide attempt. So men may use more lethal methods to avoid being seen as unmanly—even as they’re planning their own death.

Changes in gender roles may also be affecting men, suggests Sally Spencer-Thomas, executive director of the Colorado-based Carson J Spencer Foundation, whose Working Minds program promotes suicide prevention in the workplace. As more women become family breadwinners and attain leadership positions once denied them, Spencer-Thomas says that “more men are asking themselves, ‘Am I a provider or not? Am I a leader or not?’ Their sense of purpose may become unclear.”

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Whites could use a little faith. Whites are more than twice as likely to die by suicide as blacks, although whites in general are better off economically. In fact, the suicide rate for white men aged forty-five to fifty-four (29.3 per 100,000) is 14 times greater than the rate for black women of the same age (2.1 per 100,000). Some researchers suggest that blacks may be less prone to suicide because they are more religious. They tend to outpace whites in the United States on measures such as frequency of church attendance and prayer, closeness to God, and self-ratings of spirituality. Being part of a church community can also be a powerful source of social support, another protective factor.

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Midlife can be a minefield. For many people, the peak earning years of midlife offer a sense of competence and mastery. But for others, the middle years may be times of disillusionment and regret about stalled careers and stale marriages. This time of life can also be filled with anxieties about mounting debt, while putting kids through school and caring for aging parents. Plus, men at midlife discover that their own bodies aren’t what they used to be. As natural medicine expert Andrew Weil, M.D., writes, “The man at fifty or sixty looks at his sagging muscles, thinning hairline, bigger belly, and uncooperative penis and wonders, ‘Whose body is this?’”

But these challenges aren’t new to midlife. What could account for the rising suicide rates? (Remember, the latest statistics are for 2007, before the economic meltdown of 2008 brought widespread job cuts and home foreclosures.) Dr. Conwell says that even before the recession, concerns about the stability of employment could have set the stage for other factors—such as substance misuse, more difficult access to health care, and less-stable social support—that can increase the risk of suicide.

Sally Spencer-Thomas also suspects that fraying social ties may play a role. She notes a 2006 study showing that Americans’ circle of confidants shrank by one-third in the previous two decades. And the number of people who said they have no one with whom to discuss important matters more than doubled in that time, to nearly twenty-five percent.

Thomas Joiner, a psychologist at Florida State University and author of Myths about Suicide(2010), speculates that the mainstreaming of gore may even be having an effect. When the people now in their mid-40s were in their teens (from the mid-1970s to the early 1980s), they were starting to get exposed to gory movies like Halloween and Friday the 13th. He believes that one of the most important factors that contributes to suicide is a “learned fearlessness” about physical pain, physical injury, and death. (Other factors, he says, include the idea that you are a burden on other people, and the feeling that you are hopelessly alienated from them.) As people develop an increasing tolerance to gore, perhaps they are more likely—when in extreme distress—to do themselves harm.

“I hope that I’m wrong about this,” says Joiner. “If it’s true, that’s ominous.” Children and teens today are exposed to far more graphic violence in movies and computer games than were their counterparts of thirty years ago.

Other theories about why midlife suicide rates are on the rise include easier access to guns and prescription drugs, and a potentially higher incidence of depression among baby boomers.

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Lowering risk. When I asked these experts for practical advice on what middle-aged white men can do to reduce their risk of suicide, they stressed that you should see your doctor if you suspect you’re suffering from depression or another mental health problem. While depression often includes feeling sad or losing interest in things that typically give you pleasure, it can also be expressed in other ways: sleep problems, frequent headaches or stomach pain, risk taking (such as reckless driving and casual sex), and anger. If you are suicidal, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

The experts also advise all men to develop support networks, and to stay engaged with family and friends. “Do everything you can to resist the urge to isolate,” says Phillip Smith, Ph.D., a psychologist at the University of Rochester. Reaching out can feel uncomfortable, he admits. But sharing your worries can make you feel less alone, and other people may offer valuable perspectives on what you’re going through.

Dr. Conwell also encourages men to take good care of themselves. That means eating right, being physically active, managing your stress levels, getting enough sleep, and not drinking too much alcohol.

And don’t forget to look out for each other, says Spencer-Thomas. Notice if a family member, friend, or co-worker doesn’t seem himself, and ask him how he’s doing. Remind him that depression is a treatable medical condition, not a sign of weakness. If he’s talking about death and suicide, and you suspect that he might harm himself, offer to take him to the emergency room or call 911.

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A personal perspective. I am no stranger to depression, as it has affected me to varying degrees since my teens. It took me a long time to get help—first from psychotherapy, then medication, and now both. The idea of suicide once had a seductive pull on me, but it has lost its power.

Although suicide used to seem like a way out of my struggles, now I can see more options to get through them. I’ve also met several people who have lost loved ones to suicide, and now I firmly believe that any option is better than killing myself.

These survivors of suicide loss have been through a veritable hell of grief and guilt (“What could I have done to prevent this?”). If you ever get to the point that you think you’ll be doing others a favor by doing yourself in, you are wrong.

To me, the essence of suicidal thinking is a kind of tunnel vision in which self-annihilation seems like the only solution to emotional pain. Perhaps this is why I’ve found comfort in environments that provide a sense of spaciousness and openness. Sitting beneath the vaulted ceiling of my church, or walking though the woods and coming upon a sunlit clearing, seems to take me out of my head and my concerns.

In his book Man’s Search for Meaning, Victor Frankl describes a moment not long after he had been liberated from a Nazi concentration camp. He is walking through the countryside past flowering meadows. Larks rise to the sky and sing joyously. He stops, looks around, and then drops to his knees. Frankl, an Austrian Jew, repeats to himself a line from Psalm 118: “I called to the Lord from my narrow prison and He answered me in the freedom of space.”

I think it’s possible for anyone to experience this freedom of space, regardless of religious affiliation or spiritual beliefs. And I share Frankl’s sense of gratitude. I find myself released from many of the constraints that depression once placed on me and from the lure of suicidal thoughts, and I can see possibilities all around me.”